What are the complications of acute glomerulonephritis2017-05-06 10:01
The main complications of acute phase of acute phase of severe complications are severe circulatory congestion, hypertensive encephalopathy and acute renal failure. With the strengthening of prevention and control work in recent years, the incidence and mortality have decreased significantly.
1 the state of circulatory congestion: due to retention of sodium and water, blood exhaustion, until the pulmonary edema. The incidence of different reports, and the severity of illness, treatment related. From 50 to 60s in our hospital, we can see the complications of acute nephritis in children from 24% to 27%, in recent years, the report has dropped to 2.4%. More than 1 weeks to 2 weeks after onset of acute nephritis. The clinical manifestations, chest tightness, shortness of breath, not supine cough, pulmonary rales, bottom liver tenderness, gallop left and right heart failure symptoms, due to blood volume expansion caused with the real motive of different myocardial pump. The stroke volume increased, often without reducing the cycle time is normal, arteriovenous oxygen difference was increased, and digitalis effect is poor, and the use of diuretics can often be alleviated. A very small number of severe cases can develop to a true heart failure, in a few hours to 1 to 2 days of rapid pulmonary edema and life-threatening.
2 hypertensive encephalopathy: refers to blood pressure (especially diastolic pressure) increased sharply, the central nervous system symptoms. More common in children than adults. This disease is usually considered in systemic hypertension on the basis of brain resistance due to vasospasm cerebral edema caused by cerebral hypoxia; but there is someone that is a sharp increase in blood pressure, cerebral blood vessels have the original automatic Shu adjusted function control, highly vascular congestion, brain edema caused in sodium retention of acute nephritis at the onset of the disease plays a role. Occurs in the early stage of acute nephritis, generally more acute onset, manifested as severe headache, frequent nausea and vomiting, visual impairment and vertigo, diplopia, amaurosis fugax, and drowsiness or irritability, if not timely treatment of convulsion, coma, a temporary hemiplegia aphasia, severe cerebral hernia. The nervous system is not limited to the signs, shallow reflex and tendon reflex can be weakened or disappeared, ankle clonic sometimes positive, also can appear pathological reflex, serious can have cerebral hernia symptoms and signs. Fundus examination of common retinal arteriolar spasm, sometimes visible optic papilla edema. Clear cerebrospinal fluid pressure and protein, normal or slightly increased. Such as blood pressure more than 18.7/12.0kPa (140/90mmHg), and accompanied by visual impairment, convulsions and coma can be diagnosed as one of the three items.
3 acute renal failure: acute nephritis in children with a considerable portion of the acute phase of varying degrees of nitrogen, but the progress of patients with acute renal failure is only a very small number. Complications are still lack of effective preventive measures, has become the main cause of death of acute nephritis. The clinical manifestations of little or no urine, blood urea nitrogen, serum creatinine increased, hyperkalemia, metabolic acidosis. Oliguria or urine for 3 ~ 5 or more than 1 weeks, after the increase in urine output, symptoms disappeared, renal function gradually restored.